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This is a normal tissue response and not cause for concern

Warnings As with any supplement, consult your health professional before use if you are pregnant, breastfeeding, or trying to conceive, or if you are taking medication, have a medical condition, or anticipate a surgery

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Second line initiation of insulin compared with DPP-4 inhibitors after metformin monotherapy is associated with increased risk of all-cause mortality, cardiovascular events, and severe hypoglycemia

Patients improved on both sensation tests and neuropathy scores, and no side effects were reported (Ebadi et al., 2023)